CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Northwestern Medicine Central Dupage Hospital

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $73
Cash Discount Price: $126
vs. Medicare Baseline: 23.03x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Northwestern Medicine Central Dupage Hospital is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $126. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 23.03x the Medicare baseline. Located in 25 North Winfield Road, Winfield, IL.

Cash / Self-Pay

$126

Average discount available for prompt cash payment at this facility.

Insurance Median

$73

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$3.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3.17 (100%)

Cash / Self-Pay: $126 (3975%)

Insurance Median: $73 (2303%)

Cash: $126 (3975% of Medicare)

Ins. Median: $73 (2303% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $3.17 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 2303% of the Medicare baseline (a markup of 2203%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Cross Blue Shield	$6 - $200	189%
Countycare Il Cook Co [1607]	$6 - $14	189%
Medicaid / KanCare	$6 - $14	189%
Aetna	$12 - $70	379%
Carelon Behavioral Health [159]	$42 - $100	1325%
Health'S Finest Network [126]	$42 - $182	1325%
Multiplan/Phcs [142]	$48 - $200	1514%
Dreyer Med Ipa Advocate [1409]	$50 - $120	1577%
Humana	$50 - $200	1577%
Magellan Behavioral Hlth [136]	$50 - $120	1577%
Healthlink [125]	$53 - $126	1672%
Choicecare [177]	$64 - $153	2019%
First Health Plan [6034]	$65 - $154	2050%
Cigna	$67 - $160	2114%
Compsych [112]	$67 - $160	2114%
UnitedHealthcare	$84 - $200	2650%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $126.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 81001.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Northwestern Medicine Central Dupage Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 81001.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.